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HomeMy WebLinkAboutInsurance Certificate: S & S Sheetmetal Inc1 '`�"' CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 03/1312025 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY OFFICE: P.O. BOX 328 PHONE FME (AIC, No, Ext): 888-333-4949 INC,A/No): 507-446-4664 OWATONNA, MN 55060 ADDRESS: CLIENTCONTACTCENTER@FEDINS.COM INSURERS AFFORDING COVERAGE NAIC # INSURER A:FEDERATED RESERVE INSURANCE COMPANY 16024 INSURED INSURER B: S & S SHEETMETAL INC 912 ANTELOPE RD INSURER C: INSURER D: WHITE CITY, OR 97503-1607 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 245 REVISION NUMBER: 0 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUER WVD POLICY NUMBER POLICY EFF MM/DDIYVYV POLICY EXP MMIDD/YYYV LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR Y N 9910853 04/24/2025 04/24/2026 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $100,000 MED EXP (Any one person) EXCLUDED PERSONAL& ADV INJURY $1,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY ❑JPECT LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS & COMPIOP ACC $2,000,000 AOWNED AUTOMOBILE LIABILITY JANYAUTC AUTOS ONLY ASUTOSULED HIRED AUTOS ONLY NON -OWNED AUTOS ONLY Y N 9910853 04/24/2025 04/24/2026 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per Person) BODILY INJURY (Per Accident) PROPERTY DAMAGE (Per Accident) A X UMBRELLA LIAB EXCESS LIAR X OCCUR CLAIMS -MADE N N 9910854 04/24/2025 04/24/2026 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 DED I RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/ EXECUTIVE OF EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A PER STATUTE 77THER E.L EACH ACCIDENT E.L DISEASE EA EMPLOYEE E.L DISEASE POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) SEE ATTACHED PAGE CERTIFICATE HOLDER CANCELLATION 20 E MAIN ST ASHLAND. OR 97520-1814 245 0 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE t Vim'"RL I C/ ; 6 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC #: ADDITIONAL REMARKS SCHEDULE Page 1 of AGENCY NAMEDINSURED FEDERATED MUTUAL INSURANCE COMPANY S & S SHEETMETAL INC 912 ANTELOPE RD WHITE CITY, OR 97503-1607 POLICY NUMBER SEE CERTIFICATE # 245.0 CARRIER NAIC CODE EFFECTIVE DATE: SEE CERTIFICATE # 245.O SEE CERTIFICATE # 245.0 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE ADDITIONAL INSURED ALSO INCLUDES: THE CITY OF ASHLAND, OREGON, ITS OFFICERS, AGENTS AND EMPLOYEES ARE SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED BY CONTRACT ENDORSEMENT FOR BUSINESS AUTO LIABILITY. ACORD 101 (2008/01) O 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD